In November this year the CQC published data on GP’s surgeries giving them a performance rank based on 38 indicators. However, they have now had to apologise to hundreds of GP’s for giving incorrect patient safety risk assessments.
Over 60 practices have been removed from the highest risk category after a shake-up of the risk assessment factors, whilst 4 surgeries who were previously deemed to be low risk will now require an early assessment.
GP practices had been judged on 38 indicators of performance including how good doctors were at diagnosing conditions such as dementia. They were then graded in six bands from 1 (high concern) to 6(low concern). Whilst most surgeries were of low concern, 11% of surgeries were rated as being in the highest risk band.
However, investigations showed that for one indicator, whether patients had been able to get a GP or nurse appointment last time they tried, the data was so flawed that the CQC had to remove the indicator altogether. Four other indicators, Coronary heart disease incidence, Chronic obstructive pulmonary disease (COPD) incidence, Unnecessary A&E admissions and Dementia diagnosis rates had to be refined.
As a result of these changes to the bands, hundreds of surgeries will now be assigned to a different band. The CQC says that 519 practices will now move bands, although most of these are between the lowest risk categories.
One GP whose surgery was rated as “high risk” said, “Our reputation, which has been built over many years, has been tarnished by incompetence that they purport to eradicate. If they had only given us a chance to view their ratings we could have pointed out their errors and avoided this mess.” Another GP who also had a “high risk” surgery said, “My practice was rated for highest risk despite being one of the very high achieving practices in the country. The CQC claim we gave flu jabs to 24% of our patients, in fact it was over 96%. Our true rating should be for lowest risk, but the CQC aren’t interested and have not returned our calls.”
Sir Mike Richards, chief inspector of hospitals for the CQC, said, “We will make them a big apology. This only became apparent when we ran the data on the thousands of practices rather than just the hundreds that we tested them on. We are using the data to help us know where we might go first. Our judgement comes from a combination of data and inspection. The main thing that is going to matter is that we are going to be inspecting every practice.”
The British Medical Association’s GP Committee Chair, Dr Chaand Nagpaul, said: “The banding system as a whole needs to be withdrawn. We warned at the time that simplistic targets would fail to take into account the enormous pressures GP practices are facing, and that skewed and limited information does not tell us about the quality of care. These failings have the potential to seriously undermine the trust in the system and patients’ confidence in their GP and it is only right that all of those practices affected are now contacted and receive a full apology.”
Patrick Oliver, Senior Associate and Head of Clinical Negligence at Swain & Co Solicitors LLP says, “It is always important to ensure that data is correct before results are published – even more so in a sector such as medicine where negative results can impact severely on a patients confidence in their GP and harm their relationship. I hope that this error can be swiftly amended and that those surgeries who were adversely affected do not lose patients as a result of the error.”